Week 1

Question 1

Beta blocker overdose

Answer 1

Bradycardia, AV block, hypotension and DIFUSE WHEEZING

Hypoglycema, bronchospasm and neurological dysfunction (delerium)

Also cold and clamy extremities

=Sequre airway and give isotonic fluid boluses and IV atropine for treatment of hypotension and bradycardia

In patients with refactory or profound hypotension give IV glucagon

Glucagon increases intracellular levels of cAMP

Question 2

Hypertrophic cardiomyopathy

Answer 2

Question 3

Hyperkalemia

Answer 3

Question 4

Normal pressure hydrocephalus

Answer 4

Question 5

Hep A postexposure prophalaxis

Answer 5

Hep A or Hep A immune globulin in close personal contacts (sexual, houshold)

Child care contacts

Food preparation workers whose coworkers have been infected

Should be given within 2 weeks of exposure

Question 6

AVNRT

Abrupt onset of regular tachycardia that resolves with cold water immersion

2 conduction pathways (slow and fast)

reentry mechanism

Vagal maneuvers increase parasympathetic tone in the heart and result in temporary slowing of conduction in AV node and increase in the AV node refractory period leading to termination of AVNRT

Question 7

Hemodynamic measurements in shock

Answer 7

Question 8

Hepatorenal syndrome

Answer 8

Question 9

Prolonged high FIO2

Can cause oxygen toxicity as it can lead to the formation of proinflamatory oxygen free radicals and predispose to atelectasis as alveolar nitrogen is displaced, resulting in worsened oxygenation

No strict cutoff but levels less than 60% are considered safe

Question 10

Aortic stenosis

Answer 10

Progressive fatigue with exertional lightheadedness and presyncope delayed carotid pulses and systolic murmur over the right upper sternal border

Severe AS is where signs show up (Valve area less than 1 cm2_

Diminished and delayed carotid pules (pulsus parvus et tardus)

Late-peaking crecendo-decrescendo systolic murmur

Soft and single S2

Question 11

Reactive arthritis

Answer 11

Type of seronegative spondloarthropathy

Triad of nongonococcal urethritis, asymmetric oligoarthritis and conjunctivitis

OFten involves knee and sacroilliac spine

Mucucutaneous lesions and enthesitis (achilles tendon pain) are common findings

Synovial fluid analysis is usually sterile

NSAIDS are first line therapy during acute phase

Question 12

Lacunar stroke

Answer 12

Question 13

Acute Interstitial nephritis

Answer 13

Question 14

Lead poisoning in adults

Answer 14

Question 15

Evaluation of hyperthyroidism

Answer 15

Question 16

Causes of urinary incontinence in the elderly

Answer 16

Question 17

Crohn disease

Answer 17

Question 18

Dermatofibroma

Answer 18

Due to fibroblast proliferation causing isolated or multiple lesions, most comonly in lower extremities

Etiology is unknown but some pateints may develop after trauma such as bug bites

Discrete, firm, hyperpigmented nodules that are usually less than 1 cm in diamter

Fiberous component that may cause dimplin in the center when the area is pinched (dimple or buttonhole sign)

Question 19

Ichthyosis vulgaris

Answer 19

Chronic inherited skin disorder characterized by diffuse dermal scarring

Caused by mutation in filaggrin gene

Rough scale like skin

Worsens later in life and in winter

Question 20

Porphyria cutanea tarda

Answer 20

Question 21

SJS and TEN

Answer 21

Question 22

Tinea versicolor

Answer 22

Question 23

Teiogen effiuvuium

Answer 23

Question 24

crystal-induced acute kidney injury

Answer 24

Question 25

aspergilliosis

Answer 25

Question 26

Cyanide accumulation and toxicity

Answer 26

Prolonged infusion of nitropurosside at high rates

Question 27

Features of fibromyalgia, polymyositis and polymyalgia rheumatica

Answer 27

Question 28

Cognitive impairment in elderly patients

Answer 28

Question 29

Abnormal hemostasis in CRF

Answer 29

Platelet dysfunction most common PT, PTT and Platelet count normal but BT prolonged DDAVP (desmopressin) treatment of choice. Increases release of factor VII: von Willebrand factor multimers from endothelial storage sites Platelet transfusion is not indicated because transfused platelets quickly become inactive

Question 30

Length of time of liver transplant and infectious organism

Answer 30

Question 31

ADH related causes of polyuria and polydipsia

Answer 31

Question 32

Interstitial cysitis

Answer 32

Question 33

Drugs associated with pancreatitis

Answer 33

Question 34

Treatment of chronic stable angina

Answer 34

Question 35

Cryoglobulinemia

Question 36

Hypothyroidism metabolic abnormalities

Answer 36

Hyperlipidemia, hyponatremia and asymptomatic elevations of CK and serum transaminases Statins can increase the risk for myopathy in poorly controlled hypothyroidism and should be given with caution in these patients

Question 37

Colon cancer screening in patients at increased risk

Answer 37

Question 38

Type 2 heparin-induced thrombocytopenia

Answer 38

Question 39

Prevention of recurrent nephrolithiasis

Answer 39

Question 40

Vaccines for chronic liver disease

Answer 40

Question 41

Medications that improve survival in patients with LV systolic dysfunction

Answer 41

ACE inhibitors ARBs Beta blockers Mieralcorticoid receptor antagonists (spironolactone and eplerone)

Question 42

Ankylosing spondylitits

Answer 42

Question 43

Conditions that alter TBG concentration

Answer 43

Question 44

Theophylline toxicity

Answer 44

Narrow therapeutic index CNS stimulation (headache, insomnia, seizures) GI disturbances and cardiac toxicity (arrhythmia) Metabolized predominantly by the cytochrome oxidase system in the liver Inhebition by conccurent ilness (cirrhosis, cholestasis, respiratory infections with fever) or drugs (cimetidine, ciprofloxacin, erythromycin, verapamil) can cause toxicity

Question 45

Mechanical complications of acute MI

Answer 45

Question 46

Restless legs syndrome

Answer 46

Question 47

Pneumocystitis jiroveci pneumonia

Answer 47

Question 48

ROC Curve

Answer 48

Question 49

Causes of recurrent pneumonia

Answer 49

Question 50

Pancreatic adenocarcinoma

Answer 50

Question 51

Central retinal artery occlusion

Answer 51

Acute painless monocular vision loss Most commonly begins as an embolized plaque from the ipsilateral carotid artery Most patients develop significant permanent visual deficits.

Question 52

Common causes of shoulder pain

Answer 52

Question 53

General manifestations of hyperthyroidism

Answer 53

Question 54

Patellofemoral pain syndrome

Answer 54

One of the most common causes of chronic, poorly localized anterior knee pain Etiology is multifactorial and likely variable Diagnosis based on clinical findings. Atrophy or weakness of the quadriceps or hip abductors is common, and rotational or varus/valgus malalignment may also be noted Pain can often be provoked with tonic contraction of the quadriceps Management includes avoiding triggering activities and strengthening exercises

Question 55

Subdural Heamtoma

Answer 55

Question 56

Huntington disease

Answer 56

Question 57

ABGs of salicylate posoning

Answer 57

First respiratory alkalosis followed by anion gap metabolic acidosis Low PaCo2 Low HCo3 Near normal pH because the two disturbances shift the pH in opposite directions

Question 58

Nephrotic syndrome issues

Answer 58

The risk for atherosclerotic disease hypercoagulability

Question 59

Management of hypercalcemia

Answer 59

Question 60

Multiple myeloma osteolytic bony metastases

Answer 60

Serum protein electrophoresis SPEP common screening detects elevated serum monoclonal (M-spike\_ Bone marrow biopsy, more invasive, can then confirm diagnosis (more than 10 percent clonal plasma cells)

Question 61

Thyrotoxicosis

Answer 61

Question 62

Calcific uremic arteriolopathy

Answer 62

Question 63

Types of PAH

Answer 63

Question 64

Common variable immunodeficiency

Answer 64

Question 65

Acute erosive gastropathy

Answer 65

Characterized by development of hemorrhagic lesions after ischemia or the exposure of gastric mucosa to various injurious agents (alcohol, aspirin, cocaine)

Question 66

Subclavian Steal

Answer 66

OFten asymptomatic but may have symptoms of upper extremity ischemia (pain, fatigue, paresthesias) or vertebrobasilar insufficiency (dizziness, ataxia, dysequilibrium) that are worsened by upper extremity exercise

Question 67

Myasthenic crisis

Answer 67

Question 68

Acute pericarditis

Answer 68

Question 69

CSF Fluid analysis

Answer 69

Question 70

Effects of positioning in patient with pneumonia

Answer 70

Alveolar consolidation causes markedly impaired alveolar ventilation in the affected portion in the lung THis results in hypoxemia due to right-t0-left intrapulmonary shunting of blood and extreme ventelation perfusion mismatch

Question 71

HIV associated dementia

Answer 71

More likley in poorly controled HIV paitnets. CD4 less than 200 Characterized by subcortical symptoms early in course of disease Subacute onset Increased apathy and impaired attention

Question 72

clinical features of primary hyperaldosteronism

Answer 72

Question 73

Bechet disease

Answer 73

Question 74

anorectal fistula

Answer 74

Question 75

effect of maneuvers of hypertrophic cardiomyopathy

Answer 75

Question 76

prosthetic joint infection

Answer 76

Question 77

Exudative and transdative pleural effusions

Answer 77

Question 78

Hypernatremia chart

Answer 78

Question 79

Exertional heat stroke

Answer 79

Question 80

nocardiosis

Answer 80

Question 81

Approach to hyperbilirubinemia in adults

Answer 81

Question 82

Asthma treatment

Answer 82

Question 83

Splenic infarction

Answer 83

Uncommon usually arises in the setting of acute splenic artery occlusion Etiologies include hypercoagulable state, embolic disease, or hemoglobinopathy

Question 84

Pellegra

Answer 84

Niacin deficiency Dermatitis of sun-exposed areas Diarrhea Dementia Prolonged isoniazid therapy can occasionally cause

Question 85

Basal ganglia (putaminal hemorrhage)

Answer 85

Hypertensive vasculopathy most common cause

Question 86

Wilson disease

Answer 86

Question 87

Drugs for neuropathic pain

Answer 87

Question 88

Acute liver failure

Answer 88

Question 89

Peak airway pressure (max pressure measured as the tital volume is being delivered) equals the sum of the resistive pressure (flow x resistance) and the plateau pressure The plateau pressure is the pressure measured during an inspiratory hold maneuver when pulmonary airflow and thus restrictive pressure are both 0. It represents the sum of the elastic pressure and positive end-expiratory pressure

Answer 89

Question 90

Waldenstrom macroglobulinemia

Answer 90

Question 91

Causes of hypertension and hypokalemia chart

Answer 91

Question 92

IgA nephropathy vs postinfectious glomerulonephritis

Answer 92